Low rate of infusional toxicity after expanded cord blood transplantation

Adham S. Bear, Patrick J. Hanley, Doyle M. Bosque, Conrad R. Cruz, Indresh Kaur, Hao Liu, Partow Kebriaei, Chitra Hosing, Katayoun Rezvani, Betul Oran, Marcos J. De Lima, Catherine M. Bollard, Elizabeth J. Shpall

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background aims: Umbilical cord blood (CB) is used with increasing frequency to restore hematopoiesis in patients with bone marrow transplant who lack a suitable human leukocyte antigen-matched donor. CB transplantation is limited by low cell doses and delays in neutrophil and platelet engraftment. CB progenitors expanded ex vivo before transplantation provide more rapid hematopoietic and immune reconstitution as well as less engraftment failure compared with unmanipulated CB. However, the safety of infusing double and ex vivo-expanded CB has not been systematically examined. Methods: We reviewed the immediate adverse events (AE) associated with the infusion of CB occurring within 24 hours in 137 patients enrolled in clinical CB transplant trials at the MD Anderson Cancer Center from February 2004 to May 2010. All patients received an unmanipulated CB unit followed by infusion of a second unmanipulated CB unit or a second CB unit expanded ex vivo with the use of cytokines in a liquid culture system or in mesenchymal stromal cell co-cultures. Results: A total of three grade 2 and two grade 3 infusion reactions occurred within 24 hours of CB transplantation. This resulted in an AE rate of 3.7%. The majority of AEs manifested as signs of hypertension. No association with patient age, sex, disease status, premedication, ABO compatibility or total infusion volume was observed. In summary, the incidence of infusion-related toxicities in patients who receive unmanipulated and ex vivo-expanded double CB transplantation is low. Conclusions: We conclude that the infusion of unmanipulated followed by expanded CB products is a safe procedure associated with a low probability of inducing severe reactions.

Original languageEnglish (US)
Pages (from-to)1153-1157
Number of pages5
JournalCytotherapy
Volume16
Issue number8
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Fetal Blood
Transplantation
Transplants
Premedication
Hematopoiesis
HLA Antigens
Coculture Techniques
Mesenchymal Stromal Cells
Neutrophils
Blood Platelets
Cell Culture Techniques
Bone Marrow
Tissue Donors
Cytokines
Hypertension
Safety

Keywords

  • Cell culture
  • Cord blood transplantation, ex vivo expansion

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Oncology
  • Genetics(clinical)
  • Cell Biology
  • Transplantation
  • Cancer Research

Cite this

Bear, A. S., Hanley, P. J., Bosque, D. M., Cruz, C. R., Kaur, I., Liu, H., ... Shpall, E. J. (2014). Low rate of infusional toxicity after expanded cord blood transplantation. Cytotherapy, 16(8), 1153-1157. https://doi.org/10.1016/j.jcyt.2013.12.011

Low rate of infusional toxicity after expanded cord blood transplantation. / Bear, Adham S.; Hanley, Patrick J.; Bosque, Doyle M.; Cruz, Conrad R.; Kaur, Indresh; Liu, Hao; Kebriaei, Partow; Hosing, Chitra; Rezvani, Katayoun; Oran, Betul; De Lima, Marcos J.; Bollard, Catherine M.; Shpall, Elizabeth J.

In: Cytotherapy, Vol. 16, No. 8, 01.01.2014, p. 1153-1157.

Research output: Contribution to journalArticle

Bear, AS, Hanley, PJ, Bosque, DM, Cruz, CR, Kaur, I, Liu, H, Kebriaei, P, Hosing, C, Rezvani, K, Oran, B, De Lima, MJ, Bollard, CM & Shpall, EJ 2014, 'Low rate of infusional toxicity after expanded cord blood transplantation', Cytotherapy, vol. 16, no. 8, pp. 1153-1157. https://doi.org/10.1016/j.jcyt.2013.12.011
Bear, Adham S. ; Hanley, Patrick J. ; Bosque, Doyle M. ; Cruz, Conrad R. ; Kaur, Indresh ; Liu, Hao ; Kebriaei, Partow ; Hosing, Chitra ; Rezvani, Katayoun ; Oran, Betul ; De Lima, Marcos J. ; Bollard, Catherine M. ; Shpall, Elizabeth J. / Low rate of infusional toxicity after expanded cord blood transplantation. In: Cytotherapy. 2014 ; Vol. 16, No. 8. pp. 1153-1157.
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abstract = "Background aims: Umbilical cord blood (CB) is used with increasing frequency to restore hematopoiesis in patients with bone marrow transplant who lack a suitable human leukocyte antigen-matched donor. CB transplantation is limited by low cell doses and delays in neutrophil and platelet engraftment. CB progenitors expanded ex vivo before transplantation provide more rapid hematopoietic and immune reconstitution as well as less engraftment failure compared with unmanipulated CB. However, the safety of infusing double and ex vivo-expanded CB has not been systematically examined. Methods: We reviewed the immediate adverse events (AE) associated with the infusion of CB occurring within 24 hours in 137 patients enrolled in clinical CB transplant trials at the MD Anderson Cancer Center from February 2004 to May 2010. All patients received an unmanipulated CB unit followed by infusion of a second unmanipulated CB unit or a second CB unit expanded ex vivo with the use of cytokines in a liquid culture system or in mesenchymal stromal cell co-cultures. Results: A total of three grade 2 and two grade 3 infusion reactions occurred within 24 hours of CB transplantation. This resulted in an AE rate of 3.7{\%}. The majority of AEs manifested as signs of hypertension. No association with patient age, sex, disease status, premedication, ABO compatibility or total infusion volume was observed. In summary, the incidence of infusion-related toxicities in patients who receive unmanipulated and ex vivo-expanded double CB transplantation is low. Conclusions: We conclude that the infusion of unmanipulated followed by expanded CB products is a safe procedure associated with a low probability of inducing severe reactions.",
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AU - Bear, Adham S.

AU - Hanley, Patrick J.

AU - Bosque, Doyle M.

AU - Cruz, Conrad R.

AU - Kaur, Indresh

AU - Liu, Hao

AU - Kebriaei, Partow

AU - Hosing, Chitra

AU - Rezvani, Katayoun

AU - Oran, Betul

AU - De Lima, Marcos J.

AU - Bollard, Catherine M.

AU - Shpall, Elizabeth J.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background aims: Umbilical cord blood (CB) is used with increasing frequency to restore hematopoiesis in patients with bone marrow transplant who lack a suitable human leukocyte antigen-matched donor. CB transplantation is limited by low cell doses and delays in neutrophil and platelet engraftment. CB progenitors expanded ex vivo before transplantation provide more rapid hematopoietic and immune reconstitution as well as less engraftment failure compared with unmanipulated CB. However, the safety of infusing double and ex vivo-expanded CB has not been systematically examined. Methods: We reviewed the immediate adverse events (AE) associated with the infusion of CB occurring within 24 hours in 137 patients enrolled in clinical CB transplant trials at the MD Anderson Cancer Center from February 2004 to May 2010. All patients received an unmanipulated CB unit followed by infusion of a second unmanipulated CB unit or a second CB unit expanded ex vivo with the use of cytokines in a liquid culture system or in mesenchymal stromal cell co-cultures. Results: A total of three grade 2 and two grade 3 infusion reactions occurred within 24 hours of CB transplantation. This resulted in an AE rate of 3.7%. The majority of AEs manifested as signs of hypertension. No association with patient age, sex, disease status, premedication, ABO compatibility or total infusion volume was observed. In summary, the incidence of infusion-related toxicities in patients who receive unmanipulated and ex vivo-expanded double CB transplantation is low. Conclusions: We conclude that the infusion of unmanipulated followed by expanded CB products is a safe procedure associated with a low probability of inducing severe reactions.

AB - Background aims: Umbilical cord blood (CB) is used with increasing frequency to restore hematopoiesis in patients with bone marrow transplant who lack a suitable human leukocyte antigen-matched donor. CB transplantation is limited by low cell doses and delays in neutrophil and platelet engraftment. CB progenitors expanded ex vivo before transplantation provide more rapid hematopoietic and immune reconstitution as well as less engraftment failure compared with unmanipulated CB. However, the safety of infusing double and ex vivo-expanded CB has not been systematically examined. Methods: We reviewed the immediate adverse events (AE) associated with the infusion of CB occurring within 24 hours in 137 patients enrolled in clinical CB transplant trials at the MD Anderson Cancer Center from February 2004 to May 2010. All patients received an unmanipulated CB unit followed by infusion of a second unmanipulated CB unit or a second CB unit expanded ex vivo with the use of cytokines in a liquid culture system or in mesenchymal stromal cell co-cultures. Results: A total of three grade 2 and two grade 3 infusion reactions occurred within 24 hours of CB transplantation. This resulted in an AE rate of 3.7%. The majority of AEs manifested as signs of hypertension. No association with patient age, sex, disease status, premedication, ABO compatibility or total infusion volume was observed. In summary, the incidence of infusion-related toxicities in patients who receive unmanipulated and ex vivo-expanded double CB transplantation is low. Conclusions: We conclude that the infusion of unmanipulated followed by expanded CB products is a safe procedure associated with a low probability of inducing severe reactions.

KW - Cell culture

KW - Cord blood transplantation, ex vivo expansion

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